ECDC: Viral hepatitis in Europe

​Viral hepatitis affects millions of people across Europe without them even noticing – as the ‘silent disease’ often does not show any symptoms. But left untreated, hepatitis can cause irreversible liver damage.

Hepatitis is a disease with many faces and World Hepatitis Day on 28 July gives us the opportunity to increase awareness and understanding of it. Viral hepatitis is preventable – but left untreated, chronic infection with hepatitis B and C for example may progress to liver cirrhosis or cancer”, warns ECDC Director Marc Sprenger.

After several years of a declining and stabilising trend, recent food-borne outbreaks of hepatitis A indicate that hepatitis A is a re-emerging food-borne public health issue in Europe. “These outbreaks raise the question whether the EU Member States should consider options for broader vaccination recommendations against hepatitis A as this is currently only recommended to travellers”, suggests Sprenger.

The burden of hepatitis B and C in Europe

As new data from the ECDC report Hepatitis B and C surveillance in Europe 2012 show, hepatitis C causes a greater disease burden in Europe than hepatitis B with numbers and notification rates nearly twice as high as those of hepatitis B: between 2006 and 2012, more than 110 000 cases of hepatitis B and over 206 000 hepatitis C infections were recorded.

Of the 17 329 hepatitis B cases reported by 29 Member States in 2012, 2 798 (16.1%) were notified as acute, 12 306 (71.0%) as chronic and 1 865 (10.8%) as undefined. The most affected age group were those between 25 and 34 years old, accounting for a third of the cases (33.3%).

While the number of acute cases of hepatitis B has been continuously declining since 2006 – most likely thanks to vaccination programmes in many European countries – the rates of reported chronic cases have doubled from 4.3 per 100 000 population in 2006 to 8.6 in 2012.

In 2012, 30 607 cases of hepatitis C were reported from 27 EU/EEA Member States of which 509 (1.7%) were classified as acute, 3 905 (12.8%) as chronic and 23 712 (77.5%) as undefined. However, only 13 countries were able to define cases as acute or chronic. More than half (54%) of all hepatitis C cases in 2012 were diagnosed in people between 25 and 44 years of age.

“All these numbers have to be understood as an underestimate of the true situation because of under-reporting and the fact that many acute infections are asymptomatic and thus often not diagnosed. This means that the problem is more serious than we thought and we need to strengthen existing prevention and control programmes to reverse these trends”, Sprenger adds. “There is still a lot we can do to help stop the silent disease.”

ECDC co-ordinates the surveillance for hepatitis A, B and C to help countries to assess the hepatitis disease burden, evaluate existing prevention and control strategies, and to define epidemiological trends or transmission patterns across Europe.

Hepatitis is an inflammation of the liver and is most commonly caused by a viral infection. There are five known hepatitis viruses, referred to as types A, B, C, D and E. They can cause acute and in the case of hepatitis B and C also chronic liver disease.

While infection with the hepatitis A virus is typically caused by consumption of contaminated food or water and causes an acute infection, hepatitis B and C usually occur as a result of contact with infected blood or body fluids and can develop into a life-threatening chronic infection.

​Viral hepatitis affects millions of people across Europe without them even noticing – as the ‘silent disease’ often does not show any symptoms. But left untreated, hepatitis can cause irreversible liver damage.

Hepatitis is a disease with many faces and World Hepatitis Day on 28 July gives us the opportunity to increase awareness and understanding of it. Viral hepatitis is preventable – but left untreated, chronic infection with hepatitis B and C for example may progress to liver cirrhosis or cancer”, warns ECDC Director Marc Sprenger.

After several years of a declining and stabilising trend, recent food-borne outbreaks of hepatitis A indicate that hepatitis A is a re-emerging food-borne public health issue in Europe. “These outbreaks raise the question whether the EU Member States should consider options for broader vaccination recommendations against hepatitis A as this is currently only recommended to travellers”, suggests Sprenger.

The burden of hepatitis B and C in Europe

As new data from the ECDC report Hepatitis B and C surveillance in Europe 2012 show, hepatitis C causes a greater disease burden in Europe than hepatitis B with numbers and notification rates nearly twice as high as those of hepatitis B: between 2006 and 2012, more than 110 000 cases of hepatitis B and over 206 000 hepatitis C infections were recorded.

Of the 17 329 hepatitis B cases reported by 29 Member States in 2012, 2 798 (16.1%) were notified as acute, 12 306 (71.0%) as chronic and 1 865 (10.8%) as undefined. The most affected age group were those between 25 and 34 years old, accounting for a third of the cases (33.3%).

While the number of acute cases of hepatitis B has been continuously declining since 2006 – most likely thanks to vaccination programmes in many European countries – the rates of reported chronic cases have doubled from 4.3 per 100 000 population in 2006 to 8.6 in 2012.

In 2012, 30 607 cases of hepatitis C were reported from 27 EU/EEA Member States of which 509 (1.7%) were classified as acute, 3 905 (12.8%) as chronic and 23 712 (77.5%) as undefined. However, only 13 countries were able to define cases as acute or chronic. More than half (54%) of all hepatitis C cases in 2012 were diagnosed in people between 25 and 44 years of age.

“All these numbers have to be understood as an underestimate of the true situation because of under-reporting and the fact that many acute infections are asymptomatic and thus often not diagnosed. This means that the problem is more serious than we thought and we need to strengthen existing prevention and control programmes to reverse these trends”, Sprenger adds. “There is still a lot we can do to help stop the silent disease.”

ECDC co-ordinates the surveillance for hepatitis A, B and C to help countries to assess the hepatitis disease burden, evaluate existing prevention and control strategies, and to define epidemiological trends or transmission patterns across Europe.

Hepatitis is an inflammation of the liver and is most commonly caused by a viral infection. There are five known hepatitis viruses, referred to as types A, B, C, D and E. They can cause acute and in the case of hepatitis B and C also chronic liver disease.

While infection with the hepatitis A virus is typically caused by consumption of contaminated food or water and causes an acute infection, hepatitis B and C usually occur as a result of contact with infected blood or body fluids and can develop into a life-threatening chronic infection.